In Japan, the population of the elderly has sharply increased and subsequently the need to care for them has increased. Especially, the chronic diseases of the very elderly and the increasing number of those bedridden requires long-term hospitalization at hospitals and service institutions, resulting in the huge increase in both health and welfare service expenses. The introduction of the Public Long-term Care Insurance as the Social Insurance starting in the April 2000 by the Japanease Government is one of the efforts to tackle the problem.
But the risk against what the Public Long-term Care Insurance should to meet has also been met by the various Social Welfare Institutions till now. Because the direct cause of the risk, ´the need of the state of long-term care´, is various in reality, for example, ´the need´ causes from diseases, physical handicap, mental disorder, injuries in the workplace, accident, and so on. And the different welfare institution is to response the different cause of the risk in Japan. Therefore the introduction of the new Insurance need to be co-ordinated among the relating institutions to prevent the duplication or overlap the welfare bebefits.
The purpose of this study is not to describe the contents of the Public Long-term Care Insurance itself but to research the various dimensions of the inter-institutional co-ordinations among the relating welfare institutions by the introcuction of the new Insurance in Japan. This is a trial to development the new research area, ´inter-institutional co-ordination in Social Sesuruty System´.
The inter-institutional co-ordinations relation to the introduction of the new insurance is idenfied to have three dimensions in Japan; First, the new creation of the ´Care Manager´ as a profession to judge the degree of the needs for long-term care; Second, the financial co-ordinations among the municipals primary responsible for the implimentation of the Insurance to assure the quality of caregiving; And the third, the co-ordinatioms among the various welfare benefits to prevent the duplicate eligibility for the welfare services.
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